Vermont S 250: An act relating to administration of involuntary psychiatric medication in emergency circumstances

Bill Text

BILL AS INTRODUCED S.250
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VT LEG #385854 v.1
S.250 1
Introduced by Senator Collamore 2
Referred to Committee on 3
Date: 4
Subject: Health; mental health; involuntary medication; emergency 5
circumstances 6
Statement of purpose of bill as introduced: This bill proposes to allow the 7
administration of involuntary psychiatric medication in emergency 8
circumstances. 9
An act relating to administration of involuntary psychiatric medication in 10
emergency circumstances 11
It is hereby enacted by the General Assembly of the State of Vermont: 12
Sec. 1. 18 V.S.A. § 7624a is added to read: 13
§ 7624a. ADMINISTRATION OF INVOLUNTARY MEDICATION 14
EMERGENCY CIRCUMSTANCES 15
(a) In emergency circumstances where an application for involuntary 16
medication has been filed pursuant to section 7624 of this chapter, but an order 17
has not yet been issued, a patient’s treating physician may authorize the 18
administration of involuntary psychiatric medication when the following 19
conditions are met: 20

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VT LEG #385854 v.1
(1) the patient’s treating physician has informed the patient of the 1
following: 2
(A) the name and dosage of the proposed medication; 3
(B) the reason for ordering the proposed medication; 4
(C) the expected benefits of the proposed medication; 5
(D) the potential risks and side effects of the proposed medication; 6
(E) the right to refuse the proposed medication; and 7
(F) the status of the application for involuntary medication pursuant 8
to section 7624 of this title; 9
(2) the patient either orally refuses the proposed medication, cannot 10
communicate refusal, or otherwise indicates refusal of the proposed medication 11
after a reasonable attempt to obtain voluntary acceptance of the proposed 12
medication: and 13
(3) the medical director of the hospital unit or secure residential 14
recovery facility where the patient is committed and the medical director of the 15
Department have jointly determined that: 16
(A) less intrusive alternatives to the proposed medication have been 17
considered, documented in the patient’s medical record, and found unlikely to 18
meet the needs of the patient; and 19
(B) the proposed medication is necessary and the least restrictive 20
intervention reasonably required to address the emergency circumstance. 21

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(b)(1) Authority to administer the medication under this section shall expire 1
when the emergency circumstance ceases to exist or after 72 hours, whichever 2
is first occurring. 3
(2)(A) Notwithstanding subdivision (1) of this subsection (b), if the 4
emergency circumstance persists or the emergency circumstance has abated 5
because of the effect of the medication and the treating physician is of the 6
opinion that the medication is necessary to keep the emergency in abeyance 7
beyond 72 hours, then within that 72 hours, the hospital or secure residential 8
recovery facility where the patient is committed shall file a written request to 9
the court where the patient’s application for involuntary medication is pending 10
for an emergency hearing within five business days. The filing shall contain a 11
joint certification from the medical director of the hospital unit or secure 12
residential recovery facility where the patient is committed and the medical 13
director of the Department that continued medication is necessary to prevent an 14
emergency circumstance or to keep the emergency circumstance in abeyance. 15
Upon receipt of the emergency filing, the court shall review the patient’s 16
underlying application for involuntary medication in accordance with sections 17
7624 and 7625 of this chapter. 18
(B) If a complete court filing is not made within 72 hours, then the 19
medication shall be discontinued until the filing can be made, except in cases 20
where life threatening consequences could result from an abrupt medication 21

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discontinuation. Under these circumstances, the patient shall be taken safely 1
off the medication according to standards of medical practice with 2
corresponding clinical documentation. 3
(3) In no case shall a patient receive emergency medication under this 4
section for a period exceeding 10 days without an order from the court where 5
the patient’s application for involuntary medication is pending. 6
(c) Within 12 hours after administering medication pursuant to this section, 7
the treating physician shall document the basis for the emergency 8
circumstance, less intrusive alternatives considered, the type and dosage of the 9
medication administered, information provided to the patient prior to and at the 10
time of administration, the nature of the patient’s refusal or inability to refuse 11
the medication, and the clinical rationale for administration of the medication. 12
(d) As soon as practicable after the administration of medication pursuant